﻿<%@ Page Title="" Language="C#" MasterPageFile="~/admin/adminmaster.master" AutoEventWireup="true" CodeFile="trf.aspx.cs" Inherits="admin_trf" %>

<asp:Content ID="Content1" ContentPlaceHolderID="head" Runat="Server">
</asp:Content>
<asp:Content ID="Content2" ContentPlaceHolderID="ContentPlaceHolder1" Runat="Server">
<style type="text/css">
  .ui-datepicker-trigger {
    background: url("./images/EHR/icon/sprite_popups.png") no-repeat scroll 0 -25px transparent;
    border: 0 none;
    cursor: pointer;
    height: 20px;
    margin: 0 2px;
    padding: 1px 7px;
    width: 20px;
}
</style>
<div id="page-wrapper">
        <div id="main-wrapper">
            <div id="main-content">
            <div class="other-box yellow-box ui-corner-all">
                    <div class="cont  ui-corner-all">
                        <h3>
                            Welcome !</h3>
                        <p>
                            <b>Admintasia</b> is a <b>complete</b>, fully and easily customisable <b>backend administration
                                user interface</b>. Please proceed to the actual demo by clicking the <b>Ok</b>
                            button below. Enjoy !</p>
                    </div>
                </div>
                <div class="page-title ui-widget-content ui-corner-all">
                    <h1>
                        Teacher Enrollment Form</h1>
                    <div class="other">
                      <%--  <span style="color: #666">From Date:</span> <span>
                            <input type="text" id="txtCRFromDate" class="input-tran" style="width: 80px;" /></span>
            <span style="color: #666">To Date:</span> <span>
                <input type="text" id="txtCRToDate" class="input-tran" style="width: 80px;" /></span>
            <span>--%>
                        <div class="formleft" style="margin-left:0.5%">
                        <ul>
                                    <li>
                                        <label class="desc">
                                           Full Name
                                        </label>
                                        <div class="errordiv">
                                            <input type="text" name="" class="field text full" value="" maxlength="255" tabindex="1">
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                    <li>
                                        <label class="desc">
                                           Gender 
                                        </label>
                                        <div class="errordiv">
                                            <select id="ddl_Gender" name="">
                                            <option value="M">Male</option>
                                            <option value="F">Female</option>
                                            </select>
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                     <li>
                                        <label class="desc">
                                            Spouse full name
                                        </label>
                                        <div class="errordiv">
                                            <input type="text" name="" class="field text full" value="" maxlength="255" tabindex="1">
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                   
                                    
                                </ul>
                        </div >
                        <div class="formleft">
                        <ul>
                                    <li>
                                        <label class="desc">
                                           Preferred Name
                                        </label>
                                        <div class="errordiv">
                                            <input type="text" name="" class="field text full" value="" maxlength="255" tabindex="1">
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                    <li>
                                        <label class="desc">
                                            Nationality
                                        </label>
                                        <div class="errordiv">
                                            <select id="ddl_Nationality" name="">
                                            <option value="Afg">Afghanistan</option>
                                            <option value="Pak">Pakistan</option>
                                            </select>
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                     

                                    
                                </ul>
                        </div >
                        <div class="formleft" style="margin-right:0%;">
                        <ul>
                                    <li>
                                        <label class="desc">
                                            Joining Date
                                        </label>
                                        <div class="errordiv">
                                            <input type="text" name="" class="field text full" value="" maxlength="255" tabindex="1">
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                    <li>
                                        <label class="desc">
                                            Martial Status
                                        </label>
                                        <div class="errordiv">
                                             <select id="Select1" name="">
                                             <option value=""></option>
                                            <option value="Single">Single</option>
                                            <option value="Married">Married</option>
                                            </select>
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                   
                                    
                                </ul>
                        </div >
                        
                        <div class="clearfix">
                        </div>
                     
                    </div>
              


                
                    <div class="other">
                        <div class="formleft" style="margin-left:0.5%">
                        <ul>
                                    <li>
                                        <label class="desc">
                                            Address
                                        </label>
                                        <div class="errordiv">
                                            <textarea id="Textarea1" cols="35" rows="5" runat="server"></textarea>
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                    <li>
                                        <label class="desc">
                                          
                                        </label>
                                        <div class="errordiv">
                                           
                                           
                                        </div>
                                    </li>
                                     <li><br /><br />
                                        <label class="desc">
                                            City
                                        </label>
                                        <div class="errordiv">
                                            <input type="text" name="" class="field text full" value="" maxlength="255" tabindex="1">
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                      <li>
                                        <label class="desc">
                                            Country
                                        </label>
                                        <div class="errordiv">
                                            <input type="text" name="" class="field text full" value="" maxlength="255" tabindex="1">
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                    
                                </ul>
                        </div >
                        <div class="formleft">
                        <ul>
                                    <li>
                                        <label class="desc">
                                           Home Phone
                                        </label>
                                        <div class="errordiv">
                                            <input type="text" name="" class="field text full" value="" maxlength="255" tabindex="1">
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                    <li>
                                        <label class="desc">
                                            Fax
                                        </label>
                                        <div class="errordiv">
                                          <input type="text" name="" class="field text full" value="" maxlength="255" tabindex="1">
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                      <li>
                                        <label class="desc">
                                            State
                                        </label>
                                        <div class="errordiv">
                                            <input type="text" name="" class="field text full" value="" maxlength="255" tabindex="1">
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>

                                    
                                </ul>
                        </div >
                        <div class="formleft" style="margin-right:0%;">
                        <ul>
                                    <li>
                                        <label class="desc">
                                            Cell Phone
                                        </label>
                                        <div class="errordiv">
                                            <input type="text" name="" class="field text full" value="" maxlength="255" tabindex="1">
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                    <li>
                                        <label class="desc">
                                            Email
                                        </label>
                                        <div class="errordiv">
                                             <input type="text" name="" class="field text full" value="" maxlength="255" tabindex="1">
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                    <li>
                                        <label class="desc">
                                            Zip
                                        </label>
                                        <div class="errordiv">
                                            <input type="text" name="" class="field text full" value="" maxlength="255" tabindex="1">
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                    
                                </ul>
                        </div >
                       
                        <div class="clearfix">
                 
                    </div>
                </div>



                   
                    <div class="other">
                        <div class="formleft" style="margin-left:0.5%">
                        <ul>
                                    <li>
                                        <label class="desc">
                                            Degree
                                        </label>
                                        <div class="errordiv">
                                            <input type="text" name="" class="field text full" value="" maxlength="255" tabindex="1">
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                </ul>
                        </div >
                        <div class="formleft">
                        <ul>
                                    <li>
                                        <label class="desc">
                                           Certification
                                        </label>
                                        <div class="errordiv">
                                            <input type="text" name="" class="field text full" value="" maxlength="255" tabindex="1">
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                </ul>
                        </div >
                        <div class="formleft" style="margin-right:0%;">
                        <ul>
                                    <li>
                                        <label class="desc">
                                           Experiance
                                        </label>
                                        <div class="errordiv">
                                            <input type="text" name="" class="field text full" value="" maxlength="255" tabindex="1">
                                            <span class="errorspan" style = "display:none">Error message example ...</span>
                                        </div>
                                    </li>
                                </ul>
                        </div >
                       
                        <div class="clearfix">
                        </div>
                        <div class="buttonheight">
                        <div class="button float-right" style="margin-right:0.5%">
                            <a class="btn ui-state-default" href="#"><span class="ui-icon ui-icon-circle-plus"></span>
                                Registor</a>
                        </div>
                        <div class="button float-right">
                            <a class="btn ui-state-default" href="#"><span class="ui-icon ui-icon-circle-plus"></span>
                                Cancel</a>
                        </div>
                        </div>
                    </div>
               
                  </div>
               
            </div>
            <div class="clearfix">
            </div>
        </div>

    </div>
    <script type="text/javascript">
        //--------------------------------
        //    function applyDateCalenderClinicalMeasure() {
        //        $('#txtCRFromDate').datepicker({
        //            changeMonth: true,
        //            changeYear: true,
        //            showOn: "button",
        //            yearRange: "1950:+10"
        //        });
        //        $('#txtCRToDate').datepicker({
        //            changeMonth: true,
        //            changeYear: true,
        //            showOn: "button",
        //            yearRange: "1950:+10"
        //        });
        //    }
</script>

</asp:Content>

